The Influence of Cardiovascular Physiology on Dose/Pharmacokinetic and Pharmacokinetic/ Pharmacodynamic Relationships

Dublin Core

Título

The Influence of Cardiovascular Physiology on Dose/Pharmacokinetic and Pharmacokinetic/ Pharmacodynamic Relationships

Tema

FARMACOCINÉTICA

BIBLIOGRAFIA NACIONAL QUIMICA

2006

CARDIOLOGIA

Abstract

Inter- and intraindividual variability in the relationship between dose and clinical – or pharmacodynamic – response of a drug can be analysed in two steps: firstly, by considering the plasma pharmacokinetic response to a given dose and, secondly, by the connection between both pharmacokinetic and pharmacodynamic responses. As the cardiovascular system is the means of transport of endogenous and exogenous substances, blood flow fraction destined to each organ determines the relative mass of solute in plasma, which is constantly in contact with the tissue. Hence, not only the rate but also the extent of drug transfer would be increased when tissues are irrigated by a higher fraction of cardiac output. Aging and circadian rhythms present similar cardiac output distribution patterns when moving from young to aged adult and from nocturnal to diurnal hours. These two changes lead to an increased blood flow delivery to the extra-splanchnic-renal region in the elderly and in the morning, but with a decreased cardiac output in aged individuals and an increased one during the day. This scenario allows us to forecast substance concentrations outside the blood vessels, which are responsible for the extent of drug elimination and the intensity